Osteomyelitis

What is Osteomyelitis?

This is a medical word used for a bone infection. Infections may reach the bone by migrating thru the blood system or distributed from tissues which are nearby. Osteomyelitis may also start in the bone if there has been an injury that leaves the bone open to germs.

With children, osteomyelitis normally disturbs the longer bones of the upper arm or legs, though adults are likely to have osteomyelitis in the bones that structure the spinal system or vertebrae. Individuals who are diabetic can have osteomyelitis in the feet particularly if they developed ulcers of the feet.

Osteomyelitis was once considered a condition that was not curable. But treatments today are very successful. Most individuals need surgery in order to remove areas of the bone which have died – following with strong antibiotics delivered IV, normally for 6 weeks.

Osteomyelitis Symptoms

Symptoms and signs of osteomyelitis consist of:

• Chills or fever
• Pain from infection
• Lethargy or irritability in young children
• Warmth, swelling as well as redness over the infected area

Often osteomyelitis has no symptoms and signs or the signs and symptoms are too hard to separate from other problems

An individual needs to see their physician if they are having bone pain along with fever. If there is a risk of infection due to any medical problem or surgery or recent injury, see your primary care physician immediately – especially when these symptoms or signs of an infection are noticed.

Osteomyelitis Causes

Many cases of osteomyelitis develop because of a bacteria known as staphylococcus and usually live on the skin or in the nose of individuals who are healthy. These germs can enter a bone in a number of ways, including:

Thru the blood stream

Bacteria from other areas of the body – for instance, pneumonia or a urinary tract infection – may travel thru the blood system to a spot in a bone that is weak. In children, osteomyelitis is more commonly found in softer areas, known as growth plates, at either end of the long bones of the legs and arms.

Nearby infection

Severe wounds from punctures can carry bacteria very deep inside the body. If such an injury gets infected, the bacteria can migrate into any nearby bone.

Contamination which is direct

This happens when an individual has a bone that is broken so severely that a part of it might be sticking thru the skin. Direct contamination can also occur because of surgeries to replace joints or repair bones that are broken.

Osteomyelitis Diagnosis

The physician will probably order a number of tests as well as procedures in order to make a diagnosis of osteomyelitis as well as conclude which bacteria caused the infection.

Blood tests

A blood test can expose any raised levels of white blood cells and numerous factors that can be an indication that the body is battling some type of infection. If osteomyelitis is caused by an infection in the blood, these tests can reveal what bacteria is the cause. There is no blood test that can tell the physician if an individual has osteomyelitis or not. But, blood tests can offer information so the physician can decide what more tests or procedures are needed.

Imaging tests

• X-rays – These may show if there is any damage to the bone. But, damage cannot always be noticeable until osteomyelitis has existed for numerous weeks. It may be essential for images which are more detailed to show recent osteomyelitis.
• Computerized tomography or CT scan – This associates X-ray images from diverse angles, generating a comprehensive cross-sectional view of a person’s internal structures.
• Magnetic resonance imaging or MRI – This uses radio waves as well as a strong magnetic arena to yield very comprehensive pictures of bones and the soft tissues adjacent to them.

Bone biopsy

This is the gold standard for osteomyelitis diagnosis since it can likewise disclose what type of bacteria has infected the bone. This allows the physicians to prescribe an antibiotic that works well for that kind of infection. An open biopsy needs anesthesia as well as surgery in order to enter the bone. There are some situations where the surgeon inserts a very long needle thru the skin into the bone in order to take a biopsy. This needle biopsy needs local anesthetics to numb the place where the needle is introduced.

Osteomyelitis Complications

Complications of osteomyelitis can consist of:

Death of bone or osteonecrosis

Infection of the bone can hinder the circulation of the blood inside the bone, which leads to death of the bone. The bone will heal after surgery has removed small areas of bone which is dead. If a section of the bone is large and has died, the patient might need to have the limb amputated in order to stop the migrating of the infection.

Septic arthritis

Infections in bones can migrate to a adjacent joint.

Growth impairment

Children normally have osteomyelitis in the areas that are soft and referred to as the “growth plates” which are located at both ends of the long bones of the legs and arms. In these infected bones, growth that is normal can be disturbed.

Cancer of the skin

If osteomyelitis results in a sore that is open and draining pus, the skin surrounding it is at a high risk of creating squamous cell cancer.

Osteomyelitis Treatment

The gold standard for treatment of osteomyelitis includes antibiotics as well as surgery to remove any area of bone that is dead or infected.

Medications

A biopsy of the bone can tell what type of bacteria is the cause of the infection, so the physician may prescribe an antibiotic that works especially well for that type of bacteria. These antibiotics are normally administrated thru a vein in the arm for at the very least 6 weeks. The side effects include vomiting, diarrhea and nausea.

Surgery

This depends on how severe the infection is. Osteomyelitis surgery can include 1 or more of the below procedures:

Drain area infected

The area is opened up around the infected bone and any fluid or pus that might have accumulated in a response to the infection is drained off.
Remove diseased tissue and bone

The procedure is known as debridement. The surgeon gets rid of as much bone that is diseased as possible, including a slight margin of bone that is healthy to make certain that all the areas infected have been detached. The surrounding tissue showing infection also can be removed.
Restore flow of blood to bone

The surgeon can fill any space emptied by debridement process with a bone piece or other tissues, such as muscle or skin, from other parts of the body. Often fillers which are temporary can be used in the space until the patient is healthy and able to endure a tissue or bone graft. This graft aids the body to repair any blood vessels damaged as well as form new bone.
Remove any objects that are foreign

Foreign objects for instances surgical screws or plates from any previous surgery can be removed
Limb amputation

This is a last resort. Surgeons can amputate the limb that is affected so as to halt the infection from further spreading.

Osteomyelitis Pictures